[Transthoracic and transesophageal echocardiography in the study of adults with congenital cardiopathy and infectious endocarditis].
Twenty-four adults (average age 28 years) patients with congenital heart disease were examined; infective endocarditis was diagnosed in all of them by Duke criteria and was confirmed in 18 by surgery and/or pathology. Patients were divided into 2 groups. Group A was made up of 13 patients with left ventricular outflow obstruction, including ten with bicuspid aorta. Group B was made up of 11 patients with shunts (PDA or VSD), either isolated or associated with other abnormalities. The principal alterations associated with the infectious processes were trauma to the endocardium or vascular endothelium from accelerated turbulent flow (jet lesion) and valvular deformities. The principally transesophageal echocardiographic recordings showed infective vegetations on the four cardiac valves, mural endocarditis in both ventricles and right atrium, perivalvular abscesses and fistulae. The echocardiographic information aided in selecting the type of treatment in this group of patients with high intrahospital mortality (25%).